| NPI | 1972712727 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: WI 30703) |
| Additional Taxonomies | 208D00000X General Practice (Licence: VA 101051793) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2007-07-08 |